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A group of nursing students are reviewing information about counseling interventions. The students demonstrate a need for additional review when they identify counseling interventions as involving which of the following?
- A. Specific, time-limited intervention
- B. Focus on coping improvement
- C. Goal of regaining functional abilities
- D. Prevention of disability
Correct Answer: A
Rationale: Counseling interventions focus on improving coping (B), regaining function (C), and preventing disability (D), but they are not always specific or time-limited (A), as they may be ongoing or flexible. Identifying A as a key feature indicates misunderstanding.
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After teaching a group of nursing students about milieu therapy, the instructor determines that additional teaching is needed when the students identify which of the following as a key concept of milieu therapy?
- A. Structure interaction
- B. Open communication
- C. Validation
- D. De-escalation
Correct Answer: D
Rationale: Milieu therapy emphasizes a therapeutic environment with structured interaction (A), open communication (B), and validation (C) to promote healing. De-escalation (D) is a specific intervention, not a core concept of milieu therapy, indicating a need for further review.
A patient was admitted to the hospital after a suicide attempt made after his daughter was killed in an automobile accident during which he had been driving and survived with only minor injuries. Even though the accident was unavoidable, he feels responsible. During the assessment interview, the patient begins to describe the last conversation he had with his daughter before he lost control of the automobile. As he speaks about his daughter, his voice trembles, and a silent tear rolls down his face. He makes a visible attempt to straighten up and smiles superficially at the nurse, stating, 'I?ll get over this. I just need to keep a stiff upper lip. I think all I need to do is stay overnight. I?ll be as good as new by tomorrow.' Which response by the nurse would be most appropriate?
- A. Tell me about your daughter. How would you describe the relationship you had with her?
- B. I?m sure you are right; a good night?s rest should make a big difference.
- C. As good as new?
- D. You made a serious attempt on your life; you will not be ready go home by tomorrow.
Correct Answer: C
Rationale: The patient?s statement reflects minimization or denial of his emotional distress and suicide attempt. Using reflection, 'As good as new?' prompts the patient to explore his feelings further without judgment. Option A shifts focus prematurely, option B reinforces denial, and option D is confrontational, potentially shutting down communication.
The nurse is determining the success of a patient?s plan of care by evaluating outcome indicators. The nurse understands that these indicators are usually determined initially at which time?
- A. On the day of discharge
- B. During the assessment process
- C. At the initial interview
- D. With goal-setting process
Correct Answer: D
Rationale: Outcome indicators are specific, measurable criteria established during the goal-setting process in the nursing plan of care. This occurs after assessment and diagnosis, aligning interventions with desired outcomes. Discharge, assessment, and initial interviews precede or inform goal-setting.
The nurse is assessing a patient?s immediate and short-term memory. Which of the following would be most appropriate?
- A. Questioning the patient about an event that has occurred within the past several months
- B. Giving the patient a simple scenario and having him identify what would be the best response
- C. Giving the patient three words and asking him to recite them now and then in 5 minutes
- D. Asking the patient to tell the nurse the date, time, and current location
Correct Answer: C
Rationale: Testing immediate and short-term memory involves recalling information after a brief delay. Giving three words to recite now and in 5 minutes assesses both immediate recall and short-term memory. Past events test long-term memory, scenarios test judgment, and orientation tests cognitive status.
A nurse is performing a biopsychosocial assessment of a patient with depression. Which of the following would the nurse assess as part of the psychological domain? Select all that apply.
- A. Abstract reasoning
- B. Medication use
- C. Mood
- D. Orientation
- E. Self-care
Correct Answer: A,C,D
Rationale: The psychological domain includes cognitive and emotional functions such as abstract reasoning (A), mood (C), and orientation (D). Medication use (B) is part of the biological domain, and self-care (E) relates to the social or functional domain.